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Back  RFI # 166: Adjudication or Payment Date

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Submitter

Gaby Jewell

Description

The Claim Adjudication Date segment in Loop 2330B is "required when Loop-ID 2430 is not used and this payer has adjudicated the claim." DTP03 (data element 1251) is the "Adjudication or Payment Date". According to the Data Dictionary, this field is sent by the payer in the 277 transaction.

What does a provider system enter into data element 1251 when they do not receive 277 transactions from the payer, only 835 transactions?

Submitter Assigned Keywords

Adjudication, Payment Date, data element 1251

Response

Element BPR16 from the 835 should be used in the DTP03 of the Claim Adjudication Date segment in Loop 2330B to report the claim adjudication or payment date.
Submission 12/10/2004
Status Date 2/16/2005
Status F - Final
Primary References
Document 004010X096A1
Section3.1
Page415
Set ID837
Table2
Loop2330B
Segment Position350
Segment IDDTP
Element Position03
Industry NameAdjudication or Payment Date
Secondary References
RFI ID 130
Document data dict.
Section1
Page4
Set ID277
Industry NameAdjudication or Payment Date